Faculty Profiles - NAKAMURA, Masanao

Clinical significance of gastrointestinal patency evaluation by using patency capsule in Crohn's disease

Yoshimura Toru, Hirooka Yoshiki, Nakamura Masanao, Watanabe Osamu, Yamamura Takeshi, Matsushita Masanobu, Ishikawa Takuya, Furukawa Kazuhiro, Funasaka Kohei, Ohno Eizaburo, Kawashima Hiroki, Miyahara Ryoji, Goto Hidemi

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 80 ( 1 ) page： 121 - 128 2018.2

Multiple keratotic papules and plaques on the trunk in Cowden's disease with MALT lymphoma. Reviewed International journal

Sayaka Mizuno, Takuya Takeichi, Junichi Sato, Masanao Nakamura, Hidemi Goto, Kazumitsu Sugiura, Masashi Akiyama

The Journal of dermatology Vol. 45 ( 2 ) page： 238 - 240 2018.2

Associations between drugs and small-bowel mucosal bleeding: Multicenter capsule-endoscopy study. Reviewed

Niikura R, Yamada A, Maki K, Nakamura M, Watabe H, Fujishiro M, Oka S, Esaki M, Fujimori S, Nakajima A, Ohmiya N, Matsumoto T, Tanaka S, Koike K, Sakamoto C

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society Vol. 30 ( 1 ) page： 79 - 89 2018.1

Functional Correlation Between the Pancreas and the Small Intestine in Humans: The First Evaluation Using a Newly Developed Enteroscopy. Reviewed

Hayashi D, Hirooka Y, Kawashima H, Ohno E, Ishikawa T, Kuwahara T, Kawai M, Yamamura T, Furukawa K, Funasaka K, Nakamura M, Miyahara R, Watanabe O, Ishigami M, Hashimoto S, Goto H

Pancreas Vol. 47 ( 5 ) page： 601 - 608 2018

Endoscopic ultrasound in diagnosis of solid pancreatic lesions: Elastography or contrast-enhanced harmonic alone versus the combination

Chantarojanasiri Tanyaporn, Hirooka Yoshiki, Kawashima Hiroki, Ohno Eizaburo, Kuwahara Takamichi, Yamamura Takeshi, Funasaka Kohei, Nakamura Masanao, Miyahara Ryoji, Ishigami Masatoshi, Watanabe Osamu, Hashimoto Senju, Hirakawa Akihiro, Ratanachu-ek Thawee, Goto Hidemi

ENDOSCOPY INTERNATIONAL OPEN Vol. 5 ( 11 ) page： E1136 - E1143 2017.11

Development and validation of a new scoring system to determine the necessity of small-bowel endoscopy in obscure gastrointestinal bleeding Reviewed

Genta Uchida, Masanao Nakamura, Osamu Watanabe, Takeshi Yamamura, Takuya Ishikawa, Kazuhiro Furukawa, Kohei Funasaka, Eizaburo Ohno, Hiroki Kawashima, Ryoji Miyahara, Hidemi Goto, Yoshiki Hirooka

DIGESTIVE AND LIVER DISEASE Vol. 49 ( 11 ) page： 1218 - 1224 2017.11

Language：English Publishing type：Research paper (scientific journal) Publisher：ELSEVIER SCIENCE INC

Background: Small bowel capsule endoscopy (SBCE) is the recommended first-line procedure for obscure gastrointestinal bleeding (OGIB). However, a method for predicting the necessity of subsequent double-balloon endoscopy (DBE) has not been established.
Aims: We aimed to develop a new scoring system that predicts the necessity of DBE in OGIB.
Methods: A retrospective study was performed in 330 patients who underwent SBCE for OGIB at Nagoya University Hospital. The enrolled patients were randomly assigned to either a development or a validation dataset. The former was used to construct a prediction scoring system to assess the necessity of DBE using independent predictors selected by logistic regression. The diagnostic yield of the prediction model was assessed using the validation dataset.
Results: Multivariate logistic regression analysis of the development dataset identified OGIB type, blood transfusion, and SBCE findings as independent predictors of the necessity of DBE. A prediction score gave an area under the receiver operating characteristics curve of 0.77. The sensitivity, specificity, positive predictive value, and negative predictive value at a cutoff >= 2.5 points were 72.5%, 74.6%, 72.6%, and 74.5%, respectively.
Conclusion: Our scoring system may aid clinicians in deciding when to recommend DBE for patients with OGIB. (C) 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.dld.2017.08.036

【臓器間ネットワークからみた肝胆膵の恒常性とその破綻】正常状態での肝胆膵領域の臓器間ネットワーク小腸内視鏡拡大観察を用いた機能的膵小腸相関の解明

酒井大輔, 廣岡芳樹, 川嶋啓揮, 大野栄三郎, 石川卓哉, 須原寛樹, 竹山友章, 橋詰清孝, 小屋敏也, 田中浩敬, 飯田忠, 西尾亮, 鈴木博貴, 松下正伸, 山村健史, 古川和宏, 舩坂好平, 中村正直, 宮原良二, 渡辺修, 後藤秀実

肝胆膵 Vol. 75 ( 5 ) page： 929 - 936 2017.11

In vivo histological diagnosis for gastric cancer using endocytoscopy Reviewed

Issei Tsurudome, Ryoji Miyahara, Kohei Funasaka, Kazuhiro Furukawa, Masanobu Matsushita, Takeshi Yamamura, Takuya Ishikawa, Eizaburo Ohno, Masanao Nakamura, Hiroki Kawashima, Osamu Watanabe, Masato Nakaguro, Akira Satou, Yoshiki Hirooka, Hidemi Goto

WORLD JOURNAL OF GASTROENTEROLOGY Vol. 23 ( 37 ) page： 6894 - 6901 2017.10

Language：English Publishing type：Research paper (scientific journal) Publisher：BAISHIDENG PUBLISHING GROUP INC

AIM
To examine usefulness of virtual biopsy using endocytoscopy by comparing the in vivo endocytoscopic and histopathological images of gastric cancers.
METHODS
Endocytoscopy was performed in 30 patients with early gastric cancer. Of these, 26 patients showed well differentiated adenocarcinomas, while 4 patients showed poorly differentiated adenocarcinomas (including one signet ring cell carcinoma). Cancerous and non-cancerous areas were observed after double staining with 0.05% crystal violet and 0.1% methylene blue. The endocytoscopic images obtained were evaluated by an expert endoscopist and an expert pathologist without knowledge of patient clinical data, and endocytoscopic and histopathological diagnoses were compared.
RESULTS
The endocytoscopic images of the cancerous area were assessed as evaluable in 25 (83.3%) and 27 (90%) patients by endoscopist A and pathologist B, respectively, and those of the non-cancerous area as evaluable in 28 (93.3%) and 23 (76.7%) patients by the endoscopist and pathologist, respectively. The sensitivity, specificity, and diagnostic accuracy of gastric cancer diagnosis using evaluable endocytoscopic images were 88.0% and 92.9%, and 90.6% by endoscopist A, and 88.9% and 91.3%, and 90.0% by pathologist B, respectively. Evaluation of the diagnostic concordance rate between the endoscopist and the pathologist by inter-observer agreement calculation revealed no significant difference between the two observers. The inter-observer agreement (kappa-value) for endocytoscopic diagnosis was 0.745.
CONCLUSION
Endocytoscopy is useful for the differentiation of cancerous from non-cancerous gastric mucosa, making it a promising tool for virtual biopsy.

DOI： 10.3748/wjg.v23.i37.6894

ETV1 expression would be a predictive marker of malignancy in GIST

Funasaka Kohei, Miyahara Ryoji, Furukawa Kazuhiro, Matsushita Masanobu, Yamamura Takeshi, Ishikawa Takuya, Ohno Eizaburo, Nakamura Masanao, Kawashima Hiroki, Watanabe Osamu, Hirooka Yoshiki, Goto Hidemi

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY Vol. 32 page： 79-80 2017.9

Making decision to treat with infliximab by the result of periodic surveillance with double-balloon endoscopy after ilectomy can obtain mucosal healing and avoid re-operation on patients with Crohn's disease for a long-term follow-up study

Watanabe Osamu, Nakamura Masanao, Yamamura Takeshi, Matsushita Masanobu, Saito Masashi, Matsuura Rinzaburou, Sawada Tsunaki, Mizutani Yasuyuki, Niwa Yoshiki, Ishikawa Eri, Uchida Genta, Otsuka Hiroyuki, Suzuki Hiroto, Nishikawa Takahiro, Ishida Tetsuya, Yamada Keishi, Kuno Takeshi, Hattori Shun, Ishikawa Takuya, Furukawa Kazuhiro, Funasaka Kohei, Ohno Eizaburo, Miyahara Ryoji, Kawashima Hiroki, Hirooka Yoshiki, Goto Hidemi

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY Vol. 32 page： 287 - 287 2017.9

ETV1 expression would be a predictive marker of malignancy in GIST

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY Vol. 32 page： 79-80 2017.9

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY Vol. 32 page： 287-287 2017.9

Proton pump inhibitor therapy did not increase the prevalence of small-bowel injury: A propensity-matched analysis. International journal

Atsuo Yamada, Ryota Niikura, Koutarou Maki, Masanao Nakamura, Hirotsugu Watabe, Mitsuhiro Fujishiro, Shiro Oka, Shunji Fujimori, Atsushi Nakajima, Naoki Ohmiya, Takayuki Matsumoto, Shinji Tanaka, Kazuhiko Koike, Choitsu Sakamoto

PloS one Vol. 12 ( 8 ) page： e0182586 2017.8

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Previous studies have reported that the suppression of acid secretion by using proton pump inhibitors (PPIs) results in dysbiosis of the small-bowel microbiota, leading to exacerbated small-bowel injuries, including erosions and ulcers. This study was designed to assess the association between PPI therapy and small-bowel lesions after adjustment for the differences in baseline characteristics between users and non-users of PPIs. METHODS: We retrospectively studied patients suspected to be suffering from small-bowel diseases, who underwent capsule endoscopy between 2010 and 2013. We used propensity matching to adjust for the differences in baseline characteristics between users and non-users of PPIs. The outcomes included the prevalence of small-bowel lesions: erosion, ulcer, angioectasia, varices, and tumor. RESULTS: We selected 327 patient pairs for analysis after propensity matching, and found no significant differences in the prevalence of small-bowel injuries, including erosions and ulcers, between users and non-users of PPIs. Two subgroup analyses of the effect of the type of PPI and the effect of PPI therapy in users and non-users of nonsteroidal anti-inflammatory drugs indicated no significant differences in the prevalence of small-bowel injuries in these two groups. CONCLUSION: PPI therapy did not increase the prevalence of small-bowel injury, regardless of the type of PPI used and the use of nonsteroidal anti-inflammatory drugs.

DOI： 10.1371/journal.pone.0182586

Clinical factors related to false-positive rates of patency capsule examination Reviewed

Tsunaki Sawada, Masanao Nakamura, Osamu Watanabe, Takeshi Yamamura, Takuya Ishikawa, Kazuhiro Furukawa, Kohei Funasaka, Elzaburo Ohno, Hiroki Kawashima, Ryoji Miyahara, Hidemi Goto, Yoshiki Hirooka

THERAPEUTIC ADVANCES IN GASTROENTEROLOGY Vol. 10 ( 8 ) page： 589 - 598 2017.8

Language：English Publishing type：Research paper (scientific journal) Publisher：SAGE PUBLICATIONS LTD

Background: Retention is the most common complication of capsule endoscopy (CE), and is reported to occur in 0-13% of cases. To avoid retention, a PillCam patency capsule (PC) is used in patients with suspected intestinal stenosis. However, a relatively low positive predictive value of the PC examination has been reported previously. The aims of this study were to clarify the accuracy of PC examination and to evaluate clinical factors related to cases of false-positive detection.
Methods: We performed a retrospective single-center study of 282 consecutive patients referred for PC examination. Patients in which the PC could not pass through the small bowel within 33 h were classified into the 'no patency' group. The 'no patency' group was investigated for evidence of significant stenosis upon further examinations, including CE, double-balloon endoscopy, and small bowel follow-through after PC examination. Clinical factors related to small bowel patency and false-positive cases were evaluated.
Results: We included 161 male (57.1%) and 121 female (42.9%) patients with a mean age of 47.5 17.7 years. Of the 282 patients enrolled, 27 patients exhibited 'no patency' upon PC examination. Multivariate analysis showed that clinical factors related to 'no patency' included Crohn's disease, abdominal symptoms, stenosis upon imaging, and previous abdominal surgery. Upon further examination, nine cases in the 'no patency' group had significant stenosis. Sensitivity, specificity, and negative and positive predictive values of PC examination for detecting small bowel stenosis were 93.8%, 96.6%, 99.6%, and 62.5%, respectively, and the only clinical factor related to false-positive cases was constipation (p < 0.05).
Conclusion: We found a relatively low positive predictive value of PC examination and that constipation was related to false-positive results. To extend the implications of CE indications, clinical study focusing on these results is expected.

DOI： 10.1177/1756283X17722744

Quantitative diagnosis of chronic pancreatitis using EUS elastography.

Takamichi Kuwahara, Yoshiki Hirooka, Hiroki Kawashima, Eizaburo Ohno, Takuya Ishikawa, Manabu Kawai, Hiroki Suhara, Tomoaki Takeyama, Kiyotaka Hashizume, Toshinari Koya, Hiroyuki Tanaka, Daisuke Sakai, Takeshi Yamamura, Kazuhiro Furukawa, Kohei Funasaka, Masanao Nakamura, Ryoji Miyahara, Osamu Watanabe, Masatoshi Ishigami, Senju Hashimoto, Hidemi Goto

Journal of gastroenterology Vol. 52 ( 7 ) page： 868 - 874 2017.7

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: It is difficult to diagnose chronic pancreatitis (CP) objectively because of a lack of standard diagnostic criteria. Endoscopic ultrasonography (EUS) has been used to assess the severity of CP, but the diagnosis of CP using EUS depends on an endosnonographer. The aim of this study was to establish an objective diagnostic method for CP using EUS elastography (EUS-EG). METHODS: A retrospective study was designed and 96 patients underwent EUS-EG for follow-up of known CP, or who were clinically suspected as having CP. CP patients were categorized CP patients as 4 stages using the Rosemont classification (RC). EUS-EG was performed and the "Mean value", which was negatively correlated with pancreatic fibrosis, was calculated using histogram analysis. RESULTS: The "Mean value" of each RC stage (normal, indeterminate for CP, suggestive of CP, and consistent with CP) was 90.1 ± 19.3, 73.2 ± 10.6, 63.7 ± 14.2, and 56.1 ± 13.6, respectively, and showed significant differences for each stage (p < 0.001). There was a significant negative correlation between the "Mean value" and the number of EUS features (r s = -0.59, p < 0.001). Multiple linear regression analysis was used to assess the diagnostic finding of the "Mean value" and showed that hyperechoic foci with shadowing and lobularity with honeycombing maintained their independent diagnostic findings. CONCLUSIONS: EUS-EG was an objective diagnostic apparatus for CP and provided objective information to support EUS features.

DOI： 10.1007/s00535-016-1296-8

Inhibition of KDM4A activity as a strategy to suppress interleukin-6 production and attenuate colitis induction Reviewed

Kazuhiro Ishiguro, Osamu Watanabe, Masanao Nakamura, Takeshi Yamamura, Masanobu Matsushita, Hidemi Goto, Yoshiki Hirooka

CLINICAL IMMUNOLOGY Vol. 180 page： 120 - 127 2017.7

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

4-Chloro-7-nitro-2,1,3-benzoxadiazole (NBD-CI) functions as a hapten and fluoresces upon binding to proteins. Therefore, fluorescence visualization of hapten-proteins is a feature of the colitis induced by NBD-Cl. Using this colitis model, we located activated fibroblasts in the vicinity of hapten-proteins upon colitis induction and observed interleukin (IL)-6 production in the activated fibroblasts. We screened herbal ingredients using primary fibroblasts stimulated with tumor necrosis factor alpha (TNF-alpha) and found the suppressive action of Atractylodin on IL-6 production. Under TNF-alpha stimulation, Atractylodin induced the tri-methylation of histone H3 at lysine residue 9, which impaired the binding between NF-kappa B and the IL-6 promoter on the genomic DNA. Atractylodin inhibited KDM4A but not KDM6A activity. Atractylodin administration attenuated colitis induction. The KDM4A inhibitor ML324 showed similar actions on IL-6 production and colitis induction. We propose the inhibition of KDM4A activity as a strategy to suppress IL-6 production and attenuate colitis induction. (C) 2017 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.clim.2017.05.014

Combinational use of lipid-based reagents for efficient transfection of primary fibroblasts and hepatoblasts Reviewed

Kazuhiro Ishiguro, Osamu Watanabe, Masanao Nakamura, Takeshi Yamamura, Masanobu Matsushita, Hidemi Goto, Yoshiki Hirooka

BIOTECHNIQUES Vol. 63 ( 1 ) page： 37 - 39 2017.7

Language：English Publishing type：Research paper (scientific journal) Publisher：BIOTECHNIQUES OFFICE

Commercially available lipid-based transfection reagents are widely used to deliver DNA to cells. However, these lipid-based transfection reagents show poor gene transfer efficiency in primary cells. Here, we demonstrate a simple method to improve gene transfer efficiency in primary fibroblasts and hepatoblasts using a combination of lipid-based transfection reagents. Our data show that combined use of Lipofectamine LTX and FuGENE HD increases the efficiency of gene transfer compared with the use of either reagent alone, and this combination achieves the best result of any pairwise combination of Lipofectamine LTX, FuGENE HD, TransFectin, and Fibroblast Transfection Reagent.

DOI： 10.2144/000114569

Predicting the Depth of Invasion of Esophageal Squamous Cell Carcinoma: Under Experience of Linked Colored Imaging With LED Light Source

Kenichi Kobayashi, Ryoji Miyahara, Kohei Funasaka, Kazuhiro Furukawa, Masanobu Matsushita, Takeshi Yamamura, Takuya Ishikawa, Eizaburo Ohno, Masanao Nakamura, Hiroki Kawashima, Osamu Watanabe, Yoshiki Hirooka, Hidemi Goto

GASTROINTESTINAL ENDOSCOPY Vol. 85 ( 5 ) page： AB527 - AB527 2017.5

A prospective randomised study comparing double-balloon colonoscopy and conventional colonoscopy in pre-defined technically difficult cases

Despott Edward J., Murino Alberto, Nakamura Masanao, Bourikas Leonidas, Fraser Chris

DIGESTIVE AND LIVER DISEASE Vol. 49 ( 5 ) page： 507 - 513 2017.5

Language：English Publisher：Digestive and Liver Disease

Backgrounds and aim Technically ‘difficult’ (TD) colonoscopy is associated with incomplete colonoscopy, discomfort and longer procedures. Double-balloon colonoscopy (DBC) may facilitate TD colonoscopy. The primary outcome was to compare the time taken to achieve caecal intubation during conventional colonoscopy (CC) and DBC in patient with a TD colon. Methods We performed a prospective, randomised study comparing DBC and CC for TD colonoscopy. Patients were screened for parameters predictive of TD colonoscopy using an original scoring system and randomised to DBC or CC. Pain, sedation dose, colonoscopy completeness, time taken for cecal intubation, procedure completion, recovery time and patient satisfaction were recorded. Results Forty-four patients were recruited (DBC = 22; CC = 22). DBC facilitated total colonoscopy in 22 cases whereas 9 CC procedures were incomplete (P = 0.019). Median pre-procedure difficulty scores were equal for both groups (4.0 vs. 4.0). Mean patient discomfort, pain scores and recovery time were significantly lower for the DBC group (2.3 vs. 5.5, P = 0.001; 2.0 vs. 5.9, P = 0.005; 5 vs. 20 min, P = 0.014 respectively). Mean time taken for cecal intubation was similar (17.5 vs. 14 min, P = 0.18); Conclusion DBC facilitates colonoscopy completion and may be a more comfortable alternative to CC for TD cases although the time taken to achieve caecal intubation was similar.

DOI： 10.1016/j.dld.2017.01.139